A Severe Case of Buruli Ulcer Disease with Pleural Effusions

Patient GO is an 8-year-old student from Drobonso, a Buruli ulcer–endemic community in the Sekyere Afram Plains of the Ashanti region of Ghana. She presented with a month’s history of a painless nodule on the anterior chest which started increasing in size rapidly over the course of two weeks. After applying herbal preparations on the lesion and observing no improvement in symptoms, she sought medical attention through which a course of oral amoxycillin was prescribed for a week. However, her lesion continued to enlarge with involvement of her anterior and posterior chest walls and ulcerations over the left anterior cervical triangle and midsternal region. Upon the recommendation of a former patient from the same endemic region, she came to the Buruli ulcer clinic at the Agogo Presbyterian Hospital on the 24th of February 2011. On examination, the patient looked fairly stable and was afebrile (36.9uC), not pale, and anicteric with no regional lymphadenopathy. Her chest was clinically clear with a respiratory rate of 14 cycles/min. The most significant finding was an extensive oedematous lesion involving the chest and neck regions with two deep ulcerations (Figure 1). She weighed 31 kg at diagnosis (95th centile in weight for age). Swab samples obtained from the ulcer were positive by PCR for IS2404, acid-alcoholfast bacilli, and Mycobacterium ulcerans culture on Lowenstein-Jensen culture slopes.

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An article published by PLOS Neglected Tropical Diseases and available at doi:10.1371/journal.pntd.0002868

Citation

PLoS Negl Trop Dis 8(6): e2868. doi:10.1371/journal.pntd.0002868

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https://ir.knust.edu.gh/handle/123456789/11926

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